Seniors banding together to stay put

On a bluff overlooking the Potomac River, George and Anne Allen, both 82, struggle to remain in their beloved three-story house and neighborhood, despite the frailty, danger and isolation of old age.

George Allen has been hobbled since he fractured his spine in a fall down the stairs, and he expects to lose his driver's license when it comes up for renewal. Anne Allen recently broke four ribs getting out of bed. Neither can climb a ladder to change a light bulb or crouch under the kitchen sink to fix a leak. Stores and public transportation are an uncomfortable hike.

So the Allens have banded together with their neighbors, who are equally determined to avoid being forced from their homes by dependence.

Along with more than 100 communities nationwide -- a dozen of them planned here in Washington and its suburbs -- their group is part of a movement to make neighborhoods comfortable places to grow old, both for elderly men and women in need of help and for Baby Boomers anticipating the future.

"We are totally dependent on ourselves," George Allen said. "But I want to live in a mixed community, not just with the elderly. And as long as we can do it here, that's what we want."

Their group, expected to be up and running sometime next year, has registered as a nonprofit corporation and has developed a business plan based on membership dues. It is also lining up providers of transportation, home repair, companionship, daily security check-ins and other services to meet their needs at home for as long as possible.

Urban planners and senior housing experts say this movement, organized by residents rather than government agencies or social service providers, could make "aging in place" safe and affordable for the majority of elderly people.

Almost nine in 10 Americans over the age of 60, according to AARP polls, share the Allens' wish to live out their lives in familiar surroundings.

Many of these self-help communities are calling themselves "villages," playing on the notion that it takes a village to raise a child and also support the aged in their decline. Some are expected to open this fall on Capitol Hill; in Cambridge, Mass.; New Canaan, Conn.; Palo Alto, Calif.; and Bronxville, N.Y.

"Providers don't always need to do things for the elderly," said Philip McCallion, director of the Center for Excellence in Aging Services at the State University of New York at Albany. "There are plenty of ideas how to do this within the aging community."

Although not a panacea for those with complicated medical needs, the approach addresses what experts say can be a premature decision by older people to give up their homes in response to relatively minor problems: no way to get to the grocery store, difficulty persuading tradesmen to take on small repairs, the isolation of a snowy winter.

As these small problems mount, sometimes accompanied by pressure from adult children, experts say, the elderly homeowner is caught off guard. Remaining at home without sufficient help is frightening. But moving to an assisted-living center is often an overreaction that can be avoided or postponed.

"A few neighborhood-based, relatively inexpensive strategies can have an enormous effect," McCallion said. "If people don't feel so overwhelmed, they don't feel pushed into precipitous decisions that can't always be reversed."

For inspiration, the nascent groups looked to Beacon Hill Village, a Boston community that pioneered the approach six years ago.

Beacon Hill's 400 members pay yearly dues -- $580 for an individual and $780 for a couple, plus a la carte fees -- in exchange for the security of knowing that a prescreened carpenter, chef, personal trainer or home health aide is a phone call away.

Experts in aging say the self-help approach provides a sense of mastery, often lost with the move to an institution or even an adult child's spare bedroom.

That can-do spirit is attractive to Baby Boomers like Alisia Juarrero, 59, who is a board member of the Allens' group, which spans the Palisades neighborhood, an enclave of single-family houses west of Georgetown, and Foxhall, an adjacent area of attached Tudor homes.

Juarrero is mindful of the future because of the struggles of her 89-year-old mother and 92-year-old aunt in Coral Gables, Fla.

"This is where we're all headed," she said. "If I help set this up, it'll be there when I need it."

So far, most of the villages are in places where residents are well-connected and skilled in finance, law, medicine and philanthropy as a result of their own careers. That raises the question of whether the model is viable only in neighborhoods of privilege. But experts point out that most care for the elderly is already out of reach for all but the wealthy.

The amenities of an assisted-living center are far more expensive than a village's membership fee. Medicare does not pay for long-term care, and private help is costly. Only the destitute are protected in old age because Medicaid pays their nursing home fees.

A few villages are cropping up where low-income families live, such as in the Richmond District of San Francisco, with its recent wave of Russian immigrants; Falmouth, Mass., where year-round residents struggle when the summer crowd is gone; and in pockets north of New York City in Westchester County, like Yonkers, with diverse populations.

In such locations, social service organizations are likely to organize the project, instead of the older residents, and they rely on volunteers or bartered services to keep fees down. One member fixes another's faucet, banks the time and in exchange gets a ride to a medical appointment.

Groups also share expertise online and at local and national conferences, including several this past spring. Some have access to regional resource centers that help with matters like hiring an executive director or buying liability insurance.

The sprawl of suburbia presents challenges to the elderly once they cannot drive. Amid the rolling hills of Fairfax County, Va., one developing group is grappling with how to serve prospective members in a place with a single general store and five-acre zoning. Taxi vouchers may be too costly when running errands can take hours. Recruiting volunteer drivers from 118 homeowners' associations and 17 churches presents liability issues.

"The question is distance and time, and the money that relates to that," said William Cole, 77, the group's secretary-treasurer. Cole anticipates yearly dues of $1,000, which may be prohibitive for neighbors who are real estate rich but cash poor. Many of the villages are concerned about whether they can provide adequate support once the founding members, who tend to be vigorous regardless of age, decline either physically or cognitively.

The first village in the Washington area is expected to be on Capitol Hill. When it opens for business on Oct. 1, annual memberships will be $750 for a couple and $500 for an individual.

Among those eager to join are Marie Spiro, 74, and Georgine Reed, 78, who share a rambling house that they insist they will only leave "feet first."

Between them, Spiro, an emeritus professor of art history and archaeology, and Reed, a retired designer of museum exhibits, have already endured three knee replacements and an array of other ailments.

Spiro describes huffing and puffing while grocery shopping; Reed is increasingly reluctant to venture to other parts of the city to socialize with friends. Both women, who are childless, would welcome help with meals, transportation and paperwork. "I'd rather pay a fee than have to ask favors," said Spiro.